The impact of smoking on clinical outcomes after first episode psychosis: longer-term outcome findings from the EPPIC 800 follow-up study

Objective: This study aims to investigate the impact of tobacco smoking on longer-term outcomes following a first episode of psychosis. Methods: Data on 193 individuals were collected as part of a prospective follow-up visit of a cohort of patients after a mean of 7.5 years (SD = 0.8) after first treatment presentation. Primary outcome measures were positive and negative psychotic symptoms, depressive symptoms, quality of life, and global functioning at the 7.5 year follow-up. Results: Using unadjusted analyses, smoking status was linked to male gender, longer duration of untreated psychosis, more problem illicit drug use, and problem alcohol use. After adjustment for these potential confounders, smoking at baseline was not associated with poorer long-term outcomes on the primary outcome variables of interest but was associated with drug and alcohol abuse or dependence. Conclusions: These findings suggest that smoking does not appear to be associated with worse clinical and functional outcomes in psychosis.